Provider Demographics
NPI:1528263597
Name:SAVARESE, IRENE HANSEN (MS LMHC)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:HANSEN
Last Name:SAVARESE
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 N FEDERAL HWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305
Mailing Address - Country:US
Mailing Address - Phone:954-776-0406
Mailing Address - Fax:954-776-0540
Practice Address - Street 1:1995 EAST OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306
Practice Address - Country:US
Practice Address - Phone:954-776-0406
Practice Address - Fax:954-565-5102
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2193521OtherCIGNA BH